Healthcare Provider Details
I. General information
NPI: 1366869380
Provider Name (Legal Business Name): PYRAMID PHYSICIAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2014
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2680 INDIAN RIPPLE RD
BEAVERCREEK OH
45440-3605
US
IV. Provider business mailing address
2680 INDIAN RIPPLE RD
BEAVERCREEK OH
45440-3605
US
V. Phone/Fax
- Phone: 937-705-1368
- Fax: 937-298-5596
- Phone: 937-705-1368
- Fax: 937-298-5596
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HAMMAM
HADI
AKBIK
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 937-705-1368